Evidence map›Paper›PMID 40571916›Full record

Trial reportBMC anesthesiology2025

Neurally adjusted ventilatory assisted ventilation compared to pressure support during post-operative weaning of hepatic patients undergoing major abdominal surgeries: a randomized control trial.

Eman Sayed Ibrahim, Hatem A Attalah, Essam A Eid, Rasha F Elshoney, Amany A Sultan

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Eman Sayed IbrahimDepartment of Anaesthesiology, Intensive Care and Pain Management, National Liver Institute - Menoufia University, Shebeen El-Kom, Egypt. emansayed825@gmail.com.ORCID https://orcid.org/0000-0002-6850-1931
Hatem A AttalahDepartment of Anaesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt.
Essam A EidDepartment of Anaesthesiology, Intensive Care and Pain Management, National Liver Institute - Menoufia University, Shebeen El-Kom, Egypt.
Rasha F ElshoneyDepartment of Anaesthesiology, Intensive Care and Pain Management, National Liver Institute - Menoufia University, Shebeen El-Kom, Egypt.
Amany A SultanDepartment of Anaesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePatient-ventilator asynchrony (PVA) is a discrepancy between the patient’s demands and the ventilator. Pressure support ventilation (PSV) is the most popular mode of partial ventilation. Neurally adjusted ventilatory assist (NAVA) tailors the level of assistance to the diaphragm’s electromyographic activity. We aimed to evaluate the PVA during NAVA versus PSV in hepatic patients undergoing Whipple operation.

methodsThis study was a prospective, randomized, controlled double-blind trial. 120 adult Child-Pugh A and B hepatic patients of both sexes aged 18 to 65 years, undergoing Whipple operation, completed the study. We excluded severely debilitated patients and contraindications to the placement of the NAVA probe. 60 patients in the PSV (group) received PSV weaning mode, and 60 in the NAVA (group) received NAVA weaning mode. Outcome measures were asynchrony index, duration of mechanical ventilation MV, application and duration of post-extubation non-invasive CPAP, total sedating drug doses used, and ICU stay.

resultsThe total asynchrony index was lower in the NAVA group than the PSV group, 6.12 ± 1.51 and 7.06 ± 1.25%, respectively, P < 0.001(95%CI 0.43 to 1.44). Cases with total ASI ≥ 10% were lower in the NAVA group than the PSV group, 6 and 16, respectively, P 0.02.The NAVA group had better oxygenation than PSV group, PaO2 and PaO2/FiO2 ratios were 208.53 ± 14.61 vs. 188.8 ± 25.55 mmHg, p < 0.001(95%CI -27.25 to -12.20) and 521.32 ± 36.52 vs. 472.01 ± 63.88, p < 0.001 (95%CI -68.12 to -30.50) respectively. The NAVA group had a lower duration of MV (4.05 ± 0.29 vs. 4.62 ± 0.52 h; P < 0.001(95%CI 0.41 to 0.72), auto-PEEP occurrence, and total doses of fentanyl and propofol than the PSV group.

conclusionsNAVA serves better patient-ventilator interaction and synchronization than PSV, as indicated by a lower total asynchrony index, a reduced number of patients with total ASI ≥ 10%, the total doses of sedation used, the duration of MV needed, minimized need for post-extubation CPAP, and better oxygenation.

trial registrationMenoufia University Faculty of Medicine research ethics committee IRB (N. and date 3/2020/ANET9), and National Liver Institute Menoufia University Institutional Review Board (NLI IRB 000140140). The study was retrospectively registered at the Pan African Clinical Trial with identification number PACTR202401894086611 on 26 January 2024. CLINICAL REGISTRATION: The study was registered at the Pan African Clinical Trial with identification number PACTR202401894086611.

Indexed as

AbdomenInteractive Ventilatory SupportPatient-Ventilator AsynchronyPositive-Pressure RespirationPostoperative CareVentilator WeaningAdolescentAdultAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedProspective StudiesYoung AdultNeurally adjusted ventilatory assistPatient-ventilator asynchronyPressure support ventilation

Identifiers

PMID40571916
PMCPMC12199501

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.